Individual
MR. BRUCE C. BARILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5151 N 9TH AVE, PENSACOLA, FL 32504-8721
(850) 416-6020
Mailing address
PO BOX 9210, PENSACOLA, FL 32513-9210
(850) 476-8602
(850) 474-3518
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102363
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291566900
—
FL
01
—
77977
BCBS OF ALABAMA
AL
01
—
891005420
ALABAMA MEDICAID
AL
01
—
P00030954
RR MEDICARE
FL
Enumeration date
08/05/2006
Last updated
09/16/2016
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